Thrombus formation on the delivery sheath: During transcatheter atrial septal defect closure

摘要

A 50-year-old woman presented with palpitations and dyspnea. On examination, she was in sinus rhythm. Transesophageal echocardiography (TEE) showed a 26-mm secundum atrial septal defect with rims that were adequate for percutaneous transcatheter closure. The procedure was performed under TEE guidance. At the start of the procedure, the patient was given heparin (100 IU/ kg) for anticoagulation. As a 28-mm Amplatzer? Septal Occluder (AGA Medical Corporation; Plymouth, Minn) was being advanced into the left atrium, TEE revealed a 20 x 8-mm mobile thrombus at the tip of the delivery sheath (Figs. 1 and 2). A 50-cc injector was used to create negative pressure, so that the thrombus was sucked into the lumen of the delivery sheath.